Have you ever had tenderness in your buttocks from sitting for a long period of time or from sitting on a hard surface, possibly your wallet? Have you ever had lower back pain that radiated into your glute and continued down the back of your leg? Did the pain feel dull, achy, electrifying, or numb? If you answered ‘yes’ to any of these questions, then you may have experienced piriformis syndrome and sciatic nerve pain.
The piriformis is a muscle that is located deep inside the pelvis. It attaches to the front surface of the S2-S4 sacral vertebrae, the sacroiliac joint, and gluteal surface of the ilium. It extends over the sciatic nerve and attaches itself to the greater trochanter of the femur. The piriformis muscle is responsible for helping the hips rotate and turning the leg and foot outward. When there is trauma to the glute or lower back, the piriformis muscle will become inflamed, triggering muscle spasms and sending referred pain to the sacroiliac joints and compressing the sciatic nerve, which causes pain to radiate down the back of the leg. Patients who have had a total hip replacement or lower back surgery tend to experience piriformis syndrome and sciatic nerve pain.
When patients complain of chronic buttock and sciatic nerve pain, a referral to physical therapy is best to help stretch the piriformis and other lower back muscles that contribute to the constant pain. NSAIDs are recommended for inflammation, and muscle relaxants are helpful in reducing spasms.
References:
American Osteopathic Association. (2019). Piriformis syndrome: A frequently misdiagnosed pain in the buttocks. Retrieved from https://thedo.osteopathic.org/2017/09/piriformis -syndrome-frequently-misdiagnosed-pain-buttocks/
Medicalstocks. (2019). piriformis syndrome 3d medical vector illustration on white background.